Serum concentrations of advanced glycation endproducts are associated with the development of atherosclerosis as well as diabetic microangiopathy in patients with type 2 diabetes

Abstract

We measured serum concentrations of advanced glycation endproducts (AGEs) in patients with type 2 diabetes, to elucidate the mechanisms underlying the elevated serum concentrations of AGEs and to clarify the relationship between serum AGE concentrations and the development of microangiopathy and macroangiopathy. Serum AGEs were significantly higher in diabetic patients than in age-matched control subjects (p < 0.0001). In diabetic patients, serum AGEs were positively correlated with HbAlc (r = 0.47, p < 0.0001), urinary albumin excretion (UAE) (r = 0.42, p < 0.0001), diabetes duration (r = 0.31, p = 0.0030), and fasting plasma glucose (r = 0.34, p = 0.0010). Multiple regression analysis disclosed that only the HbAlc and UAE levels independently correlated with serum AGE levels. Serum AGEs in diabetic patients with progressive retinopathy and overt nephropathy were significantly higher than in those with less severe retinopathy and nephropathy. Serum AGEs were significantly higher in the diabetic patients with coronary heart disease (CHD) than in those without CHD. These results suggest that the HbAlc and UAE levels are independent risk factors for increased serum AGE concentrations in type 2 diabetic patients, and that higher serum AGE concentrations are associated with increased severity of diabetic retinopathy and nephropathy. Serum AGE concentrations may be a useful marker not only for the severity of diabetic microangiopathy but also for the development of CHD in patients with type 2 diabetes mellitus.

Retinal vascular tortuosity in persons with diabetes and diabetic retinopathy

“…Consistent with this, our earlier report from the same study sample showed that flickering light-induced arteriolar vasodilatation was substantially reduced in early to moderate DR cases but not so in VTDR cases [33]. In addition, it is also possible that less tortuous arteriolar vasculature seen in VTDR may be a result of the sclerotic process occurring in severe/proliferative DR [34,35].…”

Glycosylated Hemoglobin A1 Predicts Risk for Symptomatic Hemorrhage After Thrombolysis for Acute Stroke

“…18,19,23 Glycosylation is the link between diabetes mellitus and microangiopathy, and HbA 1c is the best established parameter for long-term diabetes mellitus control and microangiopathy, far more reliable than acute blood glucose. 24 We found HbA 1c to be strong independent predictor for any hemorrhage and also for sICH regardless of the definition used, with a cutoff value of 6.5%. This is a new finding.…”

Albuminuria and Rapid Loss of GFR and Risk of New Hip and Pelvic Fractures

“…Albuminuria is associated with inflammation and oxidative stress (23), and bones with osteoporosis are characterized by the presence of inflammatory markers and mediators (24). In the setting of diabetes, albuminuria is also associated with increased serum levels of advanced glycation end products (25). Accumulation of advanced glycation end products in bone collagen leads to inflammation, weakening of crosslinking between collagen fibrils, and loss of bone plasticity and strength (26,27).…”